| NPI | 1437860434 |
|---|---|
| Doing Business As | PARKSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | ALEX WILSON BROESDER Dentist/Owner 605-498-4746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2022-12-22 |